Health Technologies and Health Systems Workstream

Background and objectives

Genetics and genomics-based diagnosis and treatments are gradually, but many would argue fundamentally, transforming areas of healthcare.  New approaches to research, based on a very different understandings of the way in which medical interventions interact with particular patients and groups of patients, combined with new approaches such as stem cells, synthetic biology and systems biology, mean that the impact of these types of new genetics-based diagnostics and treatments is very likely to increase in the health sector over the next decades. 

Meanwhile, the ways in which these technologies will evolve and touch the lives of patients in different contexts will depend on the numerous and complex ways in which ‘health systems’ interact with, shape and are in turn influenced by new science and technology. Whilst technologies and product innovation are developed in firms and research institutes that operate globally, health systems are largely nationally based. This means that new technologies, drugs and treatments may reach various sets of patients, doctors and other consumers in radically different ways.

It is also the case that there tends to be a significant gap between researchers working on understanding innovation in life sciences and researchers looking at the development of different health systems.  Consequently, understandings of the ways in which health systems and health innovation interact with each other are poorly understood from both theoretical and empirical perspectives. The seminars organised as part of this series aim to address these gaps. The background document raises further questions and details on the seminars. The EGN Centres have long individual and combined experience working on different aspects of genomics which are being put together in this workstream. 

The workshops

Each of the EGN Centres (CESAGEN, EGENIS, INNOGEN and the Genomics Forum) will take responsibility for organising one workshop, while a final fifth workshop will draw together discussion from the other four workshops and focus on policy implications.  The series will run between December 2009 and December 2010.

•  Workshop 1 - The Impact of Genomics on Disease Classification, 2 December 2009, Cardiff University
  The above inaugural seminar was hosted successfully by Cesagen at the Milleniumm Centre in Cardiff. More than 20 people attended, representing various academic and practitioner interests in the area of disease diagnostics and classification.  In particular, the workshop examined the impacts of genomics on disease classification, reclassification of cancers and psychiatric disorders and how these may impact treatment approaches. It concluded with a look at health economics and how genomics might feed into health system decision making regarding diagnostic and treatment options. The second workshop will build on these discussions, looking in more detail at genetic subpopulations and health system responses. A detailed report and links to workshop presentations will be available on this website soon. For further details, please contact Adam Hedgecoe (hedgecoeam@cardiff.ac.uk) 
 
• Workshop 2 - Health technology assessment for genomic medicine: Challenges and prospects  Hosted on 17 September 2010 by the ESRC Genomics Policy and Research Forum, University of Edinburgh.  This workshop will be bring together invited experts in the field of HTA, members of relevant regulatory agencies, service providers, policy makers and others with a practical interest in the assessment of innovations in genomic medicine, for an exploratory discussion of the challenges faced and the kinds of solutions that might be pursued.  Formal presentations will be kept to a minimum, thereby optimising the time available for discussion and reflection.  Topics to be covered will include:

• What kind of regulatory regime is needed for genomic tests?
• Evaluating the costs of implementing new medical technologies
• Assessing the wider social costs and benefits of genomic tests
• Involving patients, citizens and civil society organisation in HTA

• Workshop 3 Genomic subpopulations and health systems responses, 11 November 2010, University of Exeter 
This third workshop continues some of the themes of the previous workshops but with a more direct emphasis on ways in which developments in the genomic subclassification of disease cohorts are met by health system responses and/or integrated with health system priorities. What impacts of genomic classification on disease management and clinical medicine are following from our increasing ability to stratify and classify biological states genomically? We will look at specific instances of health system responses to genetic heterogeneity of disease within populations to evaluate what lessons can be drawn, and what measures in terms education, infrastructure, investment in research and/or technology, and policy health systems might improve disease management. We will begin with an examination of the identification of significant genomic subpopulations with diabetes, and impacts on clinical management. We will go on to consider what implications for health systems follow from research into the genomics of common complex diseases. How are different health systems placed to respond to genetic heterogeneity in high impact diseases such as HIV/AIDS? What challenges are faced at the EU level in efforts to introduce innovations such as mass-scale genotyping of blood donors, an area of high genetic heterogeneity and impact on health care practices and health? How are advances in genetic immunotyping changing or challenging organ transplantation practices?

This event is free but registration is required. Please direct inquiries to Dr. Susan Kelly s.e.kelly@exeter.ac.uk and registration requests to Laura Dobb L.C.Dobb@exeter.ac.uk.



• Workshops 4 & 5 – Details to follow